Ketamine, the common anesthesia drug, can be effective in reducing the pressure inside the skull of children with traumatic brain injuries (TBI), a new study has found.

The study, published in Critical Care Medicine, challenges an age-old belief that the use of ketamine in patients with TBI can increase pressure inside the skull, medically known as intracranial pressure (ICP).

Ketamine is a safe, rapid-onset drug that is used as an anesthetic agent.

The study lead author, Michael Wolf, assistant professor of Pediatrics and Neurological Surgery and director of Neurocritical Care at Monroe Carell Jr. Children's Hospital at Vanderbilt, and his co-authors reexamined the effects of ketamine on ICP in children admitted to the pediatric intensive care unit with severe TBI. The researchers drew on data from 33 patients between the ages of 1 month to 16 years, and administered ketamine to 22 patients, Neuroscience News reported.

Eighteen doses were given during the ICP event to 11 patients, following which an overall decrease in skull pressure was witnessed.

"We found that not only does ketamine not raise ICP, in some cases, it may even lower it," Wolf said in the study. "Children with severe TBI are at risk of dying or having a long-term neurologic impairment, such as difficulty walking and talking. In the crucial days following their initial injury, our focus in the PICU is to minimize ongoing damage to their brains, with a focus on preventing and treating high ICP."

Ketamine may open up new possibilities to adopt a modified approach to care for vulnerable children, according to Wolf.

"Despite decades of research, our treatment options remain limited to a handful of medicines and techniques," he said. "This study might help open the door to a new use of an old drug that could help us continue to improve our approach to caring for these vulnerable children."

Wolf added the findings are still in their preliminary stages and more research will be required to determine if it will be effective in dealing with intracranial hypertension in children with severe TBI.

"This study alone represents a nearly complete reversal in how we think about the relationship between ketamine and intracranial pressure. The results will likely lead to further studies that I believe will change 20 years of past thinking," the study's co-author, John C. Wellons, the chief of Pediatric Neurosurgery at Monroe Carell, told Neurosciences.

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The study challenges an age-old belief that the use of ketamine in patients with traumatic brain injury can increase pressure inside the skull. Creative Commons